Virus fears mount in China's rural areas

May 10 2003Taipei

The World Health Organisation has advised against travel to two more Chinese provinces and the capital of Taiwan, as its experts headed to China's hinterland where they fear SARS is beginning to spread rapidly.

The WHO extended its SARS-related travel warning to the provinces of Tianjin and Inner Mongolia, as well as Taipei. The United Nations health agency had already advised against travel to Beijing, the provinces of Guangdong and Shanxi and Hong Kong.

WHO experts say China is the key to containing the global spread of the virus. Severe acute respiratory syndrome has now killed more than 500 people and infected more than 7300.

The WHO has turned its attention to the country's poorer provinces, dispatching four experts to Hebei province, which surrounds Beijing. The team, which arrived in the city of Baoding on Thursday, will inspect hospitals, talk to medical workers and visit rural areas.

In recent days an estimated million migrant workers have returned to Hebei from Beijing and other SARS-stricken areas. Eight officials in the Hebei city of Zhouzhou were fired for allowing a SARS-infected woman returning from Beijing to infect her family, state media reported.

Compounding concerns about the outbreak, Cambodian officials reported the death of seven people from an unidentified form of pneumonia in two impoverished regions near the country's border with Vietnam. WHO and Cambodian officials said there was no evidence yet the deaths were linked to SARS.

But the worst news came from Taipei, where officials reported at least six new cases of SARS that could not be traced to foreign travel or to other SARS victims. Such instances of so-called community infection have been a harbinger of much larger outbreaks to come in other countries that have been affected.

Authorities also were investigating the death of a 63-year-old man in the southern city of Kaohsiung, which represented the first SARS case outside Taipei.

Taiwan now has 132 probable cases and 14 deaths. The island trails only mainland China and Hong Kong with its case load. "It is a grim situation at the moment," said Dr Lee Ming-liang, who was recently appointed to head a SARS taskforce. "Our most important task at this point is to track down the sources of community infections."

The increases have been especially bitter for Taiwan, which has imposed some of the most draconian measures of any country in its efforts to control the disease.

Authorities require all passengers on trains and buses to wear masks, and visitors to buildings with more than 100 workers must have their temperatures taken before entering. The country also is imposing mandatory 10-day quarantines on all visitors from China, Hong Kong, Singapore and Toronto - a step that is devastating its economy.

Taiwanese President Chen Shui-bian told his cabinet on Thursday night that he would order the army and police to take a more active role in enforcing the quarantine and pursuing violators.

The initial assessment of a WHO epidemiological team - the first representatives of that agency to visit the island in 30 years - did not provide any comfort, criticising the country's initial efforts at containment.

"There is some concern that they are not taking proper infection control measures and that, when a case is identified, they do not have the procedures to make sure that person is isolated," said Maria Cheng, a WHO spokeswoman.